The Investigation of Brainerd Diarrhea

Carl W. Walter, MD
JAMA. 1986;256(21):2963. doi:10.1001/jama.1986.03380210059021.
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To the Editor.—  The epidemiologic extravaganza entitled "An Outbreak of a Newly Recognized Chronic Diarrhea Syndrome Associated With Raw Milk Consumption"1 was dominated by a statistical analysis that ignored its barren etiologic base. Only a sparse 18 lines of text were devoted to the putative source of the infection—the dairy farm. Pertinent microbiological or veterinary expertise was evidently not involved. Pheasants, pigeons, and poultry were not investigated. Epizootic bovine chlamydial infections in dairy cattle were not considered.2The lack of a truly multidisciplinary investigation may have permitted Chlamydia psittaci to escape the hopper of epidemiologic analysis. Pasteurization will control milk-borne transmission, but leaves the zoonosis as a rural occupational3 and community hazard.


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